
Exercises 5 & 6:
Although seated exercises are low impact and are typically performed
indoors, I feel it is important to provide information regarding
the potential hazards of exercising at any level during the warmest
months of the year. Exercising during the summer months can be
dangerous for any exerciser if they do not maintain adequate levels
of hydration. Prevention of dehydration and heat related illnesses
should be part of the exercise education.
Physiologically, the human
body produces 5-10 times more heat during exercise versus rest.
Excess heat is dissipated through sweat and is often understood
as the human cooling system. Humidity interferes with sweat evaporation
and cooling becomes more and more difficult. If the body is under
a state of dehydration it cannot cool itself efficiently and the
body’s ability to sweat becomes more and more compromised.
As a result, the body will try to keep blood away from the skin
to keep blood pressure appropriate at the core level in order
to sustain cardiac output. Eventually, an ongoing battle between
the skin and the muscles takes place as leg and arm muscles demand
more blood in order to supply much needed oxygen and vital nutrients
to sustain the muscle contraction and relaxation. At the same
time the skin needs an adequate amount of blood sent in its direction
to transport the heat to the peripheral level to cool the body
off. The cardiovascular system is caught in the middle trying
to satisfy both mechanisms. As a result, heart rate increases
to sustain stroke volume which is necessary to maintain cardiac
output.
Signs of heat related
illnesses and dehydration:
Heat Exhaustion: Overall weakness, headache or dizziness, rapid
heartbeat, cold clammy skin and nausea. These signs and symptoms
begin suddenly, sometimes after excessive perspiration and inadequate
fluid intake.
Heat Stroke: Elderly
and obese individuals are at highest risk. Other risk factors
for heat stroke include constant daily dehydration, alcohol use,
heart disease and vigorous exercise. Heat stroke occurs when the
body loses the battle with heat exhaustion. The body stops sweating
and temperature rises rapidly, heartbeat is rapid and shallow
breathing occurs. Victims may become delirious and/or confused.
Fainting can be the first sign in the elderly.
Dehydration: Marked
thirst, infrequent urination, dry mouth, nausea, headache, dizziness
and or light-headedness.
Heat Cramps: Painful muscle spasms. Usually occurs after vigorous
exercise and possibly during the nighttime when individuals are
asleep.
It is important for health
care professionals to share with their patients’ safety
tips to ensure safe outdoor exercise.
Some of these symptoms also parallel symptoms of low blood sugar,
therefore carrying your meter along with glucose tablets and water
in a waist pack is always wise.
Tips for safe exercise
during the summer months:
1. If the temperature is greater than 85 degrees and the humidity
is greater than 75%, it is best to exercise indoors. If outdoors
is a must, exercise early in the morning, after breakfast or later
in the evening after your evening meal. Always avoid the 10am-4pm
window as temperatures are at their peak.
2. Always wear loose-fitting, light colored, cotton or mesh clothing.
Shorts, a sleeveless shirt, low cut socks and a hat are recommended
to aid in heat loss (e.g. sweat).
3. Drink plenty of water, at least 64oz/day if not more considering
the amount lost during exercise. Avoid sports drinks as they contain
many carbohydrates. It is a good idea to carry bottled water during
exercise and try to consume 4-8oz. of water every 15 minutes during
moderate aerobic exercise.
4. Always start exercise with a 5-10 minute warm-up and finish
the exercise with another 5-10 minute active cool-down.
5. Be sensible about your levels of exertion, and listen to your
body.
6. Gardening and other various types of yard work are considered
lifestyle activities and although they do not aid in improving
cardiovascular fitness, it can put you at risk for a heat-related
illness if heavy amounts are performed during the 10am-4pm window.
References:
Diabetes Management Therapies, a core curriculum for Diabetes
Education, Fourth Edition. The American Association of Diabetes
Educators, 2001.
The “I hate to exercise book” for people with diabetes.
Charlotte Hayes, MMSc, MS, RD, CDE. American Diabetes Association,
2000.
The Best is yet to come, an exercise handbook.. D. Bruckerhoff,
RN, Certified Exercise Specialist. Boone Hospital Center, WELLAWARE.
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